Accuracy and Reliability of Visual Inspection and Smartphone Applications for Measuring Finger Range of Motion

Measurement of finger range of motion is critical in clinical settings, especially for outcome analysis, clinical decision making, and rehabilitation/disability assessment. Although goniometer measurement is clinically considered the gold standard, its accuracy compared with the true radiographic measurements of the joint angles remains questionable. The authors compared 3 smartphone applications and visual inspection measurements of the finger joints with the radiographic measurements and determined interrater reliability for these measurement tools. A finger was held in place using an aluminum-alloy splint, and a fluoroscopic image was acquired by a mini C-arm. An independent observer measured each joint flexion angle of the fluoroscopic image using a universal handheld goniometer, and this was used as the reference. Finger joint flexion angles were then independently measured by 3 observers using 3 different smartphone applications. In addition, visual inspection was used to estimate the flexion angles of finger joints. The results of this study suggest that all 3 smartphone measurement tools, as well as visual inspection, agree and correlate well with the reference fluoroscopic image measurement. Average differences between the fluoroscopic image measurements with the measured angles using the tools studied ranged from 9.4° to 12.2°. The mean correlation coefficients for each smartphone application exceeded 0.7. Overall interrater reliabilities were similar, with the interclass correlation coefficient being greater than 0.9 for all of the measurement tools. These data suggest that new smartphone applications hold promise for providing accurate and reliable measures of range of motion. [Orthopedics. 2018; 41(2):e217-e221.].